99m Tc-HYNIC-TOC人体内照射剂量研究

卢麟俊, 许晓平, 徐俊彦, 张建岗, 章英剑, 宋少莉, 张建平

  1. 1. 复旦大学附属肿瘤医院核医学科，复旦大学上海医学院肿瘤学系，上海 200032 ；
    2. 复旦大学生物医学影像研究中心，上海 200032 ；
    3. 上海分子影像探针工程技术研究中心，上海 200032 ；
    4. 上海市质子重离子医院核医学科，上海 201321 ；
    5. 复旦大学核物理与离子束应用教育部重点实验室，上海 200433

  • 出版日期:2020-11-30 发布日期:2020-12-07
  • 通讯作者: 张建平 E-mail: zhangjianpin82@126.com
  • 基金资助:
    上海市卫健委面上项目（201740185）；上海分子影像探针工程技术研究中心项目（19DZ2282200）；国家自然科学基金（81771861，81971648）；上海市科技创新计划（18410711200，19142202100）；国家重点研发计划（2019YFC1604605）。

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摘要/Abstract

摘要： 背景与目的：放射性显像药物在人体内的剂量分布、各器官的吸收剂量及全身有效剂量数据非常重要。研究 99m Tc标记的经肼基烟酰胺修饰的奥曲肽（ 99m Tc-Hydrazinonicotinyl-Tyr3-Octreotide， 99m Tc-HYNIC-TOC）在人体内各器官的吸收剂量、全身吸收剂量及全身有效剂量。方法：对2018年5—6月复旦大学附属肿瘤医院收治的5例神经内分泌肿瘤患者静脉注射370 MBq  99m Tc-HYNIC-TOC后于0.5、1.0、2.0、4.0和8.0 h行全身平面采集，其中2.0 h平面采集后即刻行全身断层采集。断层数据经迭代重建后，将数据导入GE Dosimetry Toolkit处理，在单光子发射计算机断层显像（single photon emission computed tomography，SPECT）/CT融合图像上勾画各器官生成感兴趣区（region of interest，ROI），获得相应时间-活度曲线并计算曲线下面积得到滞留时间。依据美国核医学会医用内照射剂量学（Medical Internal Radiation Dose，MIRD）委员会提出的内照射剂量计算方法（MIRD体系），利用OLINDA/EXM软件计算 99m Tc-HYNIC-TOC在人体内各器官的吸收剂量、全身吸收剂量和全身有效剂量。结果：脾脏、膀胱、肾脏的单位活度吸收剂量较高，男性分别为0.042、0.019和0.016 mGy/MBq，女性分别为0.026、0.027和0.017 mGy/MBq。大脑、皮肤、甲状腺的单位活度吸收剂量较低，男性分别为0.000 3、0.000 5和0.000 5 mGy/MBq，女性分别为0.000 3、0.000 5和0.000 6 mGy/MBq。对放射线敏感的器官如骨原细胞、胸腺和红骨髓的单位活度吸收剂量均较低，范围为0.001 2~0.002 2 mGy/MBq。全身平均单位活度吸收剂量男性为0.001 7 mGy/MBq，女性为0.0016 mGy/MBq。全身单位活度有效剂量男性为0.004 58 mSv/MBq，女性为0.004 55 mSv/MBq。结论： 99m Tc-HYNIC-TOC可安全地用于人体，其有效剂量低于允许范围上限。该研究结果可为临床安全使用 99m Tc-HYNIC-TOC提供依据，也为其他放射性药物的安全性评估和加快临床转化提供新的可行方案。

关键词: 99m Tc标记的经肼基烟酰胺修饰的奥曲肽, 生物分布, 医用内照射剂量学方法, 人体吸收剂量

Abstract: Background and purpose: The data of radioactive imaging drug dose distribution in human body, absorbed dose of organs and effective dose of whole body are very important. The purpose of this study was to estimate the absorbed doses of different organs and the effective dose from the biodistribution of the  99m Tc-hydrazinonicotinyl-Tyr3-octreotide ( 99m Tc-HYNIC-TOC) in humans with hybrid single photon emission computed tomography (SPECT) imaging. Methods: Whole body planar imaging was acquired at 0.5, 1.0, 2.0, 4.0 and 8.0 h after administration of 370 MBq  99m Tc-HYNIC-TOC to 5 patients with neuroendocrine tumors who were treated in Fudan University Shanghai Cancer Center from May to Jun. 2018, and the tomography of the whole body was achieved at 2.0 h. After iterative reconstruction, the data were imported into GE Dosimetry Toolkit. Region of interest (ROI) of different organs was delineated in SPECT/CT images, and the residence time equal to the area under the curve was calculated by time-activity curve. The absorbed doses of different organs and the whole body and the effective dose of whole body were calculated by OLINDA/EXM software according to the standard methods which were developed by Medical Internal Radiation Dose (MIRD) Committee. Results: The absorbed dose coefficients of spleen, bladder and kidney (adult male: 0.042, 0.019 and 0.016 mGy/MBq; adult female: 0.026, 0.027 and 0.019 mGy/MBq) were much higher than those of brain, skin and thyroid (adult male: 0.000 3, 0.000 5 and 0.000 5 mGy/MBq; adult female: 0.000 3, 0.000 5 and 0.000 6 mGy/MBq). The range of absorbed dose coefficients of radiosensitive organs such as osteogenic cells, thymus and red marrow was 0.001 2-0.002 2 mGy/MBq. The absorbed dose coefficient of whole body was 0.001 7 mGy/MBq for adult male and 0.001 6 mGy/MBq for adult female. The effective dose coefficient of whole body was 0.004 58 mSv/MBq for adult male and 0.004 55 mSv/MBq for adult female. Conclusion:  99m Tc-HYNIC-TOC is feasible to be used safely in human beings because the effective dose of whole body is lower than dose constraining. This study can provide the basis for using  99m Tc-HYNIC-TOC safely in the clinical practice.

Key words:  99m Tc-Hydrazinonicotinyl-Tyr3-Octreotide, Biodistribution, Medical Internal Radiation Dose methods, Human absorbed dose

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